ByStephen Kurczy, CorrespondentNovember 17, 2013

Rio De Janeiro — Eliane Antunes doesn't expect her grandchildren to walk through gunfire. But in Maré, a shantytown abutting Rio de Janeiro's international airport, their walk to school passes through a war zone between rival drug gangs.

A widow, Antunes receives $72 per month from Bolsa Família to care for two grandsons, whose mother is a drug addict. It supplements her monthly income of $314 as a housecleaner.

"Bolsa Família helps to pay for food, cooking gas," says Antunes, who has been on the program since 2003. "On a good day we have chicken."

Such benefits, and challenges to staying enrolled, have given recipient families an incentive to demonstrate regular use of educational and medical services, says Rômulo Paes de Sousa, the former vice minister of social development. "When families are forced to visit hospitals and send children to school, they raise concerns about the quality of public services," Mr. Paes says. Problems complying with Bolsa don't defeat the program, but make the entire social structure stronger, he says.

"Families are very careful to stay on Bolsa Família," says Nubia Erineuba, a social worker at Redes de Desenvolvimento da Maré, a nongovernmental organization. "When they're cut off or suspended, they ask us how to get back on."

That was the case this month with Adriana Lima da Silva, a young mother of five who lives in Maré. Sometimes violence prevents her children from attending school or receiving health checkups, although last month a mere scheduling conflict caused her to miss a postnatal appointment for her two youngest children, which automatically suspended her family's November check of $69. Most of that money typically goes toward day care.

"The schools and clinics will excuse us if we can't come because of the violence," she says. "But if it's negligence, we're suspended." So long as she brings her children to this month's doctor's appointment, she'll be back on Bolsa Família, she says.